erythroderma
Erythroderma is a general term referring to many skin lesions (including erythroderma, a variant of T-cell lymphoma); characterized by generalized reddening of the skin with pronounced large-lamellar peeling. Frequency – 1% of all hospitalizations for skin diseases, more often men (2: 1) over 40 years of age get sick. Etiology and risk factors
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- Toxicodermia
- Lymphomas
- contact dermatitis
- Atonic dermatitis
- colon cancer
- fungal diseases
- HIV infection
- Ichthyosoform dermatoses
- Leukemia
- Lichen planus
- Lungs’ cancer
- myeloma
- Pemphigus foliaceus
- Photodermatitis
- Ringworm red hair
- Psoriasis
- pyoderma
- Reiter’s syndrome
- Scabies
- Seborrheic dermatitis
- Cesare syndrome
- Lyle’s disease
- Stasis dermatitis
- SLE
- Toxic epidermal necrolysis.
Genetic aspects. To date, 2 inherited forms have been identified (173200, ED, pityriasis rubra pilaris; 270300, p, congenital exfoliative keratosis).
Clinical picture
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- In the early stages
- With an acute onset or development of the disease against the background of exudative dermatitis – thinning of the epidermis, erythema, exudation with subsequent formation of crusts
- Exacerbation of a concomitant disease, then fine-lamellar generalized peeling with non-cordial erythema and lichenification of the skin
- In the absence of a concomitant disease – a predominant lesion of the skin of the trunk, perineum and head, then – generalization of lesions.
- In the next
- Severe itching, feeling of thickening of the skin, dry mucous membranes, nail dystrophy, baldness
- Malaise, tachycardia, chills, fever
- Lymphadenopathy
- Liver enlargement, spleen enlargement (if there is associated lymphoma or leukemia)
- Gynecomastia
- Steatorrhea.
Research methods
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- Blood test: moderate leukocytosis, eosinophilia, micro- and macrocytic anemia, increased ESR, hypoalbuminemia, electrolyte disturbances
- Biopsy of skin, lymph nodes, and bone marrow to identify underlying disease. differential diagnosis. Acute dermatoses, for example, contact dermatitis and toxicosis.
Treatment:
Tactics of conducting
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- Cancellation of products that cause exacerbation of the skin process
- Treatment of comorbidities, antibiotics or antifungals for superinfection
- With unclear etiology – symptomatic therapy; probably an unexpected cure. Drug therapy
- Glucocorticoids, for example, prednisolone 40 mg / day orally, if there is no effect, the dose is increased by 20 mg / day each
dye 3-4 days (no more than 100 mg / day). Subsequently, the dose is reduced to maintenance
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- Glucocorticoids locally – with localized lesions
- Glucocorticoids should be used with caution in exfoliative dermatitis caused by atonic or seborrheic dermatitis
- Contraindications – exfoliative dermatitis in psoriasis.
- Antihistamines – to relieve itching.
- With erythroderma due to psoriasis – methotrexate, etretinate, phototherapy and other specific treatments.
- With erythroderma caused by mycosis fungoides, photochemotherapy.
- With erythroderma due to tinea pedis, isotretinoin.
Complications
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- Bacterial, fungal superinfection
- Dehydration, electrolyte disturbances
- Heart failure. The prognosis for patients with idiopathic exfoliative dermatitis is unfavorable.
Synonym. Exfoliative dermatitis ICD. L26 Exfoliative dermatitis